Key result
Single pancreas transplant recipients show FMD comparable to healthy controls and superior to kidney recipients.
Why the study?
Patients with diabetes treated with pancreas transplantation normalize hyperglycemia but may have impaired endothelial function due to immunosuppressive drugs.
Does single pancreas transplantation impair endothelial function in patients with diabetes mellitus?
Observational (n=230)
No
Does single pancreas transplantation impair endothelial function in patients with diabetes mellitus?
Absolute Event Rate: 8.7% vs 7.7%
p-value: p=.06
Endothelial function, measured by flow-mediated dilatation, is preserved in patients undergoing pancreas transplantation despite the use of immunosuppressive drugs.
Single pancreas transplant may preserve endothelial function in diabetes; supports vascular benefit but leaves open need for randomized confirmation.
BACKGROUND: Patients with diabetes mellitus treated with successful pancreas transplantation (PTX) normalize hyperglycemia, but are exposed to immunosuppressive drugs that may impair endothelial function. This study aimed to evaluate endothelial function in single PTX recipients. METHODS: Flow-mediated dilatation (FMD) in the brachial artery was measured by ultrasound 8 weeks after transplantation in single PTX (n = 27) and compared with healthy controls (n = 58), simultaneous pancreas and kidney recipients (n = 9), and kidney transplant recipients with (n = 41) and without (n = 95) diabetes mellitus. Adjustments for age, gender, blood pressure, and body mass index were included in a linear regression model. Changes in FMD from before to 1 year after transplantation were assessed in a subgroup of PTX recipients (n = 9). RESULTS: Flow-mediated dilatation% in PTX recipients was not inferior to healthy controls (8.7 ± 3.6 vs 7.7 ± 3.3, P = .06) and simultaneous pancreas and kidney recipients (6.7 ± 4.5, P = .24) in an adjusted model, and superior to kidney recipients with and without diabetes (3.0 ± 3.0 and 4.8 ± 3.3, respectively, both P < .005). FMD% improved significantly from eight weeks to one year after PTX, mean 7.9 ± 4.2% vs 11.8 ± 4.8% (N = 9; P = .03). CONCLUSION: Flow-mediated dilatation is well preserved in patients undergoing pancreas transplantation and is not impaired when immunosuppressive drugs are introduced.
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Nordheim et al. (2020) conducted an observational in Diabetes mellitus (n=230). Single pancreas transplantation vs. Healthy controls and other transplant recipients was evaluated on Flow-mediated dilatation (FMD) in the brachial artery at 8 weeks (p=.06). Flow-mediated dilatation in single pancreas transplant recipients was not inferior to healthy controls (8.7% vs 7.7%, P=0.06) and superior to kidney recipients with and without diabetes (P<0.005).
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